Tropical mayhem: a chronic viral disease with superadded parasitic infection

Coexistence of two illnesses in the same patient may result in atypical manifestations of either or both diseases. A case of hepatitis B virus-related cirrhosis in a patient who presented with a pharyngeal mucosal mass lesion as a manifestation of superadded Leishmania infection is presented here. The clue to the diagnosis was the origin of the patient from an area highly endemic for leishmaniasis and the presence of unexplained polyclonal hypergammaglobulinaemia. The patient responded very well to therapy with amphotericin B with complete disappearance of the mucosal lesion.

Regulation of oxidative stress–mediated apoptosis by diallyl sulfide in DMBA-exposed Swiss mice

Diallyl sulfide, a sulfur-containing volatile compound present in garlic ( Allium sativum), exerts anticarcinogenic activity in various rodent tumor models. In the present study, apoptosis-inhibiting effects of diallyl sulfide against a carcinogenic polycyclic aromatic hydrocarbon, 7,12-dimethyl benz(a)anthracene (DMBA), in Swiss albino mice were observed. The animals were given either 250 μg/mouse or 500 μg/mouse of diallyl sulfide for 1 week after a single intragastric dose of 7,12-dimethyl benz(a)anthracene (50 mg/kg body weight). Results showed that diallyl sulfide supplementation effectively protects against 7,12-dimethyl benz(a)anthracene—induced oxidative stress, characterized by restored antioxidant enzyme levels (up to 64%) and lipid peroxidation (up to 25%). Flow cytometric analysis showed a reduction in apoptotic cell population in hypodiploid region in diallyl sulfide–supplemented animals. Inhibition of apoptosis was preceded by decrease in reactive oxygen species levels and restoration of mitochondrial transmembrane potential followed by decreased DNA fragmentation. In 7,12-dimethyl benz(a)anthracene–exposed animals, downregulation (~30%) of antiapoptotic Bcl-2 and upregulation (~60%) of pro-apoptotic Bax proteins were observed. These alterations were restored significantly by diallyl sulfide supplementation, indicating inhibition of apoptosis. Thus, these results show that diallyl sulfide provides protection against oxidative damage induced by 7,12-dimethyl benz(a)anthracene in mouse liver and may be an effective chemopreventive and therapeutic agent by modulating expression of cell-growth regulatory proteins.

Growth and biochemical parameters of Cicer arietinum L. grown on amended fly ash

Growth and metal accumulation were investigated in two Cicer arietinum L. varieties (var. CSG-8962 and var. C-235) when grown in various combinations of fly ash (FA) amended with garden soil (GS), press mud (PM) or saw dust (SD). In addition, the levels of photosynthetic pigments, nitrate reductase (NR) activity, cysteine, non-protein thiols (NP-SH), and ascorbic acid were studied. FA amended with GS or PM led to a 5-10 times increase in biomass compared to FA control and was most pronounced in the less metal tolerant variety CSG-8962. Amendment of FA with either GS or PM only moderately increased the contents of some essential metals whereas the non-essential Cd and Cr remained similar or decreased slightly compared to FA control. FA combined with either GS or PM increased the amount of photosynthetic pigments and was largely absent when SD was added to FA. Improved nitrogen availability led to increased nitrate reductase (NR) activity with all amendments but less so with SD. Metal stress indicating parameters were generally reduced (cysteine and non-protein thiols) or unchanged (ascorbic acid). In conclusion, of the tested ameliorants both GS and PM greatly improved growth of C. arietinum making FA a suitable component of plant growth substrates.

Expression of the TMPRSS2:ERG fusion gene predicts cancer recurrence after surgery for localised prostate cancer

The prostate-specific gene, TMPRSS2 is fused with the gene for the transcription factor ERG in a large proportion of human prostate cancers. The prognostic significance of the presence of the TMPRSS2:ERG gene fusion product remains controversial. We examined prostate cancer specimens from 165 patients who underwent surgery for clinically localised prostate cancer between 1998 and 2006. We tested for the presence of TMPRSS2:ERG gene fusion product, using RT–PCR and direct sequencing. We conducted a survival analysis to determine the prognostic significance of the presence of the TMPRSS2:ERG fusion gene on the risk of prostate cancer recurrence, adjusting for the established prognostic factors. We discovered that the fusion gene was expressed within the prostate cancer cells in 81 of 165 (49.1%) patients. Of the 165 patients, 43 (26.1%) developed prostate-specific antigen (PSA) relapse after a mean follow-up of 28 months. The subgroup of patients with the fusion protein had a significantly higher risk of recurrence (58.4% at 5 years) than did patients who lacked the fusion protein (8.1%, P<0.0001). In a multivariable analysis, the presence of gene fusion was the single most important prognostic factor; the adjusted hazard ratio for disease recurrence for patients with the fusion protein was 8.6 (95% CI=3.6–20.6, P<0.0001) compared to patients without the fusion protein. Among prostate cancer patients treated with surgery, the expression of TMPRSS2:ERG fusion gene is a strong prognostic factor and is independent of grade, stage and PSA level.

Estimation of intraocular pressure in rabbits using noncontact tonometer: a comparative evaluation with Schiotz tonometer

Estimation of intraocular pressure in rabbits is often done by indentation tonometry using Schiotz tonometer. The use of Schiotz tonometer for estimation of intraocular pressure requires the use of topical anesthesia, poses risk of infection and injury to cornea and puts the animal under stress. Therefore, in this study noncontact tonometer was used to estimate intraocular pressure in rabbits and the technique is described for the first time. Twenty-five rabbits were subjected to intraocular pressure estimation using Schiotz as well as noncontact tonometer by two independent observers. All intraobserver and interobserver differences were within two standard deviation from the mean, indicating good repeatability and reproducibility of the two methods. A good linear correlation was observed between measurements done by Schiotz and noncontact tonometers with the correlation coefficient (r(2)) of 0.9122 and regression equation y = 1.632x + 4.8684. No significant difference was observed in percent change in intraocular pressure in timolol-treated, water-loaded rabbits using noncontact tonometer and Schiotz tonometer. Noncontact tonometer provides an easy, quick and safe method for intraocular pressure estimation, which is comparable to the conventional method of Schiotz tonometry. Therefore, despite the cost, noncontact tonometry seems to have a greater scope in experimental studies.

Poverty, health & intellectual property rights with special reference to India

This paper examines the nexus between poverty and global health with specific focus on IPR protection and attempts to highlight the current global endeavours to overcome barriers to access to medicines for diseases of the poor. The number of very poor people in the world has increased by 10.4 per cent between 1987 and 2001 to 2735 million. India is now home to the largest number of millionaires in the developing countries. But over 800 million Indians who still survive on Rs 20.0 (US$0.5) a day, and rural poverty is on the rise. The link between poverty and health is well established with the underprivileged are more vulnerable to major health risks due to poor nutrition, inadequate access to clean drinking water, sanitation, exposure to indoor smoke, etc. all of which contribute to the huge and growing burden of disease in the poor countries. The global disease burden is not just huge but growing: over 10 million children die of preventable conditions including vaccine-preventable diseases, about 14 million are killed by infectious diseases every year, 90-95 per cent in poor countries. An estimated third of global population has limited or no access to essential medicines. While the number of poor and unhealthy is growing, Government expenditure on health is dwindling. Many of the diseases of the poor require new medicines and none are forthcoming as there is little R&D for these infections. There are several barriers to access to existing and the newly discovered drugs. One major reason is the general lack of interest by the pharma industry to discover new medicines for diseases of the poor due to very limited market in developing countries. In addition, global intellectual property rights (IPR) protection regimes like the Trade Related Intellectual Property Rights (TRIPS) are considered a major obstacle for the poor access to medicines. There have been some global initiatives on the need to improve affordability and accessibility of medicines. Some strategies to promote R&D on diseases of the poor such as Prize Fund Model, the Medical R&D Treaty and steps to invoke flexibilities in TRIPS read with Doha Declaration are discussed. Health of the poor is a global problem that requires global solutions with global participation and commitment.

Transcriptome analyses of benign and malignant prostate epithelial cells in formalin-fixed paraffin-embedded whole-mounted radical prostatectomy specimens

Formalin-fixed paraffin-embedded (FFPE) prostate specimens are rich sources of molecular pathological information. However, FFPE-based microarray analysis of tissue samples may be hampered by the degradation and chemical alteration of RNA molecules due to the preservation procedure. In this report, we employed a probe analyses of Affymetrix oligonucleotide arrays at individual probe level to compensate for the potential loss of gene identifications associated with compromised mRNA quality in FFPE preparations. Furthermore, to increase the sample quality, we utilized laser capture microdissection of prostate tumor and benign epithelial cells. Remarkably, combination of these approaches recapitulated the common prostate cancer-associated gene expression alteration. Identification of prostate cancer associated-gene expression alterations such as AMACR, Kallikrein gene family and genes associated with androgen signaling such as PDEF and STEAP were consistent with previous findings reported in prostate cancer. These data suggest that combination of laser capture dissection with computational enhancement of microarray data may be useful for the assessment of gene expression changes in FFPE prostate cancer specimens.

Cytochromes P450 catalyze oxidation of alpha,beta-unsaturated aldehydes

We sought to establish whether heme-thiolate monooxygenases oxidize, alpha,beta-unsaturated aldehydes generated during lipid peroxidation. Several recombinant P450s co-expressed with NADPH:P450 oxidoreductase were surveyed for aldehyde oxidation activity with anthracene-9-carboxaldehyde and 4-hydroxy-trans-2-nonenal (HNE). Murine P4502c29, human P4503A4, human P4502B6, and rabbit P4502B4 were good catalysts of aldehyde oxidation to carboxylic acids. Other P450s (e.g., P4501A2, 2E1, and 2J2) did not oxidize these aldehydes. P4502c29 and P4503A4 displayed K(m)/S(0.5) values of approx. 1-20microM. The product measured by HPLC that co-migrates with authentic 4-hydroxynonenoic acid (HNA) had a mass spectrum identical to the standard. Using P4502c29, HNE was a mixed-competitive inhibitor of anthracene-9-carboxaldehyde oxidation, suggesting that both aldehydes are substrates for P4502c29. Specific inhibitors of aldehyde dehydrogenases and P450 were used to assess their role in the metabolism of HNE in primary rat hepatocytes. Inhibitors of aldehyde dehydrogenase (cyanamide) inhibited HNA formation by 60% and together cyanamide and miconazole (P450) caused over 85% inhibition of HNA formation. P450s are significant participants in metabolism of endogenous and exogenous unsaturated aldehydes in primary rat hepatocytes.

Experimental evidence for a new parameter to control the glass transition of confined polymers

Polymer nanocomposites can be used to study confinement effects on the polymer glass transition temperature (Tg) in a controlled manner by varying interparticle spacing. Using gold nanoparticles in polymethylmethacrylate, we show how the polymer Tg can be tuned by variation of the nanoparticle-polymer interface width (sigma), keeping interparticle spacing fixed. We report the first experimental observation of a crossover in the sign of Tg deviation for confined polymers by variation of sigma and propose a model to explain the dependence of crossover width on the spatial extent of cooperatively rearranging regions.

Phytochelatins and antioxidant systems respond differentially during arsenite and arsenate stress in Hydrilla verticillata (L.f.) Royle

Serious contamination of aquatic systems by arsenic (As) in different parts of the world calls for the development of an in situ cost-effective phytoremediation technology. In the present investigation, plants of Hydrilla verticillata (L.f.) Royle were exposed to various concentrations of arsenate (As(V)) (0-250 microM) and arsenite (AsIII) (0-25 microM) and analyzed for accumulation responses vis-à-vis biochemical changes. Total As accumulation was found to be higher in plants exposed to AsIII (315 microg g(-1) dw at 25 microM) compared to As(V) (205 microg g(-1) dw at 250 microM) after 7 d of treatment. Plants tolerated low concentrations of As(III) and As(V) by detoxifying the metalloid through augmented synthesis of thiols such as phytochelatins and through increased activity of antioxidant enzymes. While As(V) predominantly stimulated antioxidant enzyme activity, As(III) primarily caused enhanced levels of thiols. The maximum amount of As chelated by PCs was found to be about 39% in plants exposed to As(III) (at 10 microM) and 35% in As(V) exposed plants (at 50 microM) after 4 d. Only the respective highest concentrations of As(III) (25 microM) and As(V) (250 microM) proved toxic for normal plant growth after prolonged treatment. Thus, H. verticillata forms a promising candidate for the phytoremediation of As contaminated water.

Isoniazid induces oxidative stress, mitochondrial dysfunction and apoptosis in Hep G2 cells

Isoniazid (INH) continues to be a sheet anchor in treatment of tuberculosis, however its chronic administration is known to cause hepatotoxicity through a poorly defined mechanism. Ellucidation of mechanism underlying INH induced hepatotoxicity may be beneficial in devising ways to counteract toxic manifestations. In view of this concentration dependent effects INH were evaluated in hepatoma cell line (Hep-G2). INH exposure produced cytotoxic effects in Hep-G2 cells in a characteristic dose dependent manner. There was considerable cell detachment, loss of viability and alterations in cellular morphology that were indicative of toxic insult. We observed cell shrinkage at highest concentrations (88 microM) suggesting an involvement of apoptosis. This finding was substantiated by the flow cytometry data and DNA fragmentation analysis which clearly indicated that INH induced cytotoxicity, was being mediated by induction of apoptosis. Furthermore there was mitochondrial dysfunction as indicated by significant inhibition of MTT Reduction as compared to control at all the concentrations and depletion of cellular glutathione (GSH) content along with increased production of Reactive oxygen species (ROS). Collectively these findings led us to conclude that INH induced apoptosis in Hep-G2 cells is mediated by generation of oxidative stress.

Healthcare-associated infections in neonatal units: lessons from contrasting worlds

Neonatal intensive care units are vulnerable to outbreaks and sporadic incidents of healthcare-associated infections (HAIs). The incidence and outcome of these infections are determined by the degree of immaturity of the neonatal immune system, invasive procedures involved, the aetiological agent and its antimicrobial susceptibility pattern and, above all, infection control policies practised by the unit. It is important to raise awareness of infection control practices in resource-limited settings, since overdependence upon antimicrobial agents and co-existing lack of awareness of infection control is encouraging the emergence of multi-drug-resistant nosocomial pathogens. We reviewed 125 articles regarding HAIs from both advanced and resource-limited neonatal units in order to study risk factors, aetiological agents, antimicrobial susceptibility patterns and reported successes in infection control interventions. The articles include surveillance studies, outbreaks and sporadic incidents. Gram-positive cocci, viruses and fungi predominate in reports from the advanced units, while Gram-negative enteric rods, non-fermenters and fungi are commonly reported from resource-limited settings. Antimicrobial susceptibility patterns from surveillance studies determined the empirical therapy used in each neonatal unit. Most outbreaks, irrespective of the technical facilities available, were traced to specific lack of infection control practices. We discuss infection control interventions, with special emphasis on their applicability in resource-limited settings. Cost-effective measures for implementing these interventions, with particular reference to the recognition of the role of the microbiologist, the infection control team and antibiotic policies are presented.

Androgen receptor and prostate cancer

Since the original observations of Huggins and Hodges that prostate cancers are androgen dependent, androgen ablation therapy has been the gold standard for the treatment of advanced prostate cancer (CaP). Androgen receptor (AR) is believed to play critical roles in the development and progression of CaP. Treatment for neoadjuvant, adjuvant and recurrent disease all center on the regulation and manipulation of the androgen pathway, in which AR plays an integral role. Recent discoveries that frequent overexpression of ETS-related proto-oncogenes may be driven by AR as a consequence of common genomic rearrangements can hold the key towards the understanding of early phases of prostate cancer. Furthermore, AR function evolves as the cell changes towards a clinically androgen depletion independent state. Comprehension of AR function, regulation and abnormalities are increasingly refined towards the understanding of the role of AR in CaP, and in therapeutic applications. Development of future therapy for CaP will be aided by improving the knowledge of dysfunctions of AR and its network in prostate cancer. This review focuses salient features of AR and on the recent advances addressing AR dysfunctions in prostate cancer.

Growth performance and biochemical responses of three rice (Oryza sativa L.) cultivars grown in fly-ash amended soil

The disposal of fly-ash (FA) from coal-fired power stations causes significant economic and environmental problems. Use of such contaminated sites for crop production and use of contaminated water for irrigation not only decreases crop productivity but also poses health hazards to humans due to accumulation of toxic metals in edible grains. In the present investigation, three rice cultivars viz., Saryu-52, Sabha-5204, and Pant-4 were grown in garden soil (GS, control) and various amendments (10%, 25%, 50%, 75% and 100%) of FA for a period of 90 days and effect on growth and productivity of plant was evaluated vis-a-vis metal accumulation in the plants. The toxicity of FA at higher concentration (50%) was reflected by the reduction in photosynthetic pigments, protein and growth parameters viz., plant height, root biomass, number of tillers, grain and straw weight. However, at lower concentrations (10-25%), FA enhanced growth of the plants as evident by the increase of studied growth parameters. The cysteine and non-protein thiol (NP-SH) content showed increase in their levels up to 100% FA as compared to control, however, maximum content was found at 25% FA in Saryu-52 and Pant-4 and at 50% FA in Sabha-5204. Accumulation of Fe, Si, Cu, Zn, Mn, Ni, Cd and As was investigated in roots, leaves and seeds of the plants. Fe accumulation was maximum in all the parts of plant followed by Si and both showed more translocation to leaves while Mn, Zn, Cu, Ni and Cd showed lower accumulation and most of the metal was confined to roots in all the three cultivars. As was accumulated only in leaves and was not found to be in detectable levels in roots and seeds. The metal accumulation order in three rice cultivars was Fe > Si > Mn > Zn > Ni > Cu > Cd > As in all the plant parts. The results showed that rice varieties Saryu-52 and Sabha-5204 were more tolerant and could show improved growth and yield in lower FA application doses as compared to Pant-4. Thus, Sabha-5204 and Saryu-52 are found suitable for cultivation in FA amended agricultural soils for better crop yields.

Patient satisfaction following abdominoplasty: an NHS experience

Abdominoplasty is one of the few cosmetic procedures performed in the UK on the National Health Service (NHS). In the current climate of tight resource rationing many primary care trusts (PCTs) are refusing to fund such operations, resulting in a number being carried out in the independent sector. There are very few studies in the literature on patient satisfaction following abdominoplasty, with none from the UK. Our study aimed to look at the patient satisfaction rate following abdominoplasty in the NHS and study further the areas of dissatisfaction. A questionnaire survey was sent to 153 patients who underwent the procedure over a 5-year period. Replies were received from 118 (78%) patients, revealing a 77% satisfaction rate amongst responders. Further analysis of the dissatisfied patients revealed particular dissatisfaction with dog-ears, residual abdominal overhang and issues relating to the scar. The dissatisfied group was exclusively female from across the age spectrum, although analysis showed an increase in dissatisfaction with time, with the highest levels seen at 4-6 years post-abdominoplasty. This study has identified a number of areas of patient dissatisfaction, even in carefully selected patients.